Diagnosis: blocked!

Joanne Bowman, RVT, shares a special bond with Angel, a courageous Shih Tzu.

What do a girl and a puppy have in common? Much more than you might think. That's the lesson I learned a few years ago when I met a 6-month-old female Shih Tzu I'll call Angel. Angel's owners brought her to our clinic with symptoms of vomiting, anorexia, and weight loss. When I took the puppy's history, I learned she'd scavenged in the trash a few weeks before. Although it had been a couple weeks since Angel's dumpster dive, I noted the event in her chart.

During Angel's first day in our hospital, she vomited once, acted lethargic, and had a small amount of loose stool with a 102-degree temperature. Radiographs revealed no apparent obstructions—only several tiny mineral-density objects in the small intestine. By day two, Angel's symptoms disappeared. A second radiograph indicated the mineral-density objects were moving into her colon.

However, on day three, Angel vomited hourly, moaned, and cried and shivered with severe cramps. Her liquid brown eyes begged me to help her. We radiographed her body again and saw it: a mass in the small intestine with a large gas bubble behind it. We raced to surgery. Amongst the trash, we found several pieces of sharp, hard plastic, which had gouged holes in Angel's small intestine. How she ate and eliminated was a mystery.

The doctor removed a baseball-sized mass of plastic and fibers and examined the damage. Then he grimly removed his gloves and called the owners. The doctor explained Angel only had a 2-percent chance for survival—even if we extracted the damaged portion of her intestine and sutured the healthy ends together. Tears welled in my eyes. I prayed—more than usual—Angel's owners would let us try to save the dog. Why did I feel such a close connection with Angel?

A special bond

Bowman (center) pictured with friends minutes before the picnic supper when she passed out from internal bleeding caused by a ruptured spleen.

Remember the girl I mentioned earlier? That was me. The year before, I was catching in the seventh inning of a sandlot softball game. The batter hit a fly ball between me and the pitcher. We both ran for it—hard. The instant the ball fell into the pitcher's glove, we collided with an "oof." We both scrambled to our feet. I caught my breath and finished the game. But I didn't know I was bleeding internally from a ruptured spleen. We were giving thanks for our picnic supper when the pain and blood loss caught up with me and I passed out.

Doctors removed my spleen and sent me home two days later. The next afternoon, I was vomiting and having diarrhea, so I returned to the emergency room. After countless tests and intravenous fluid therapy, my doctors decided I needed surgery. They removed 6 inches of tangled intestine and set me on the path to recovery.

The fight to survive

So what happened to Angel? Her owners begged us to save her, so we did our best. The doctor removed two-thirds of her small intestine. I held her close as she came out of the anesthetic. I fought back the tears that threatened to spill down my cheeks and prayed she would heal as I had.

For the next week, I devoted myself to her care, regularly bringing fresh, soft blankets and hand-feeding Angel when the doctor allowed her to eat. Angel reminded me of my own illness, and I felt driven to offer her the exceptional nursing care I'd received. Every time she whined, I remembered when I cried in pain. When her appetite returned, I recalled the first time I felt hunger again after surgery. And although I hated to see her go, when we discharged Angel to jubilant owners, I celebrated her freedom, too.

While the causes of our blockages were different, the skilled care of our surgeons and nurses helped us both heal. When our team sent Angel home, I knew I'd miss her, but her family's gratitude made it easier to say goodbye.

Today, I feel more empathy for my patients. Pain management is one of my first thoughts when we face a difficult surgery. And it serves as a special reminder when I hear that diagnosis: blocked!